New Pneumococcal Vaccine Recommendations

27 Mar

With all the attention Covid-19 has received over the past two years, it’s easy to think it’s the only infection that matters. But, of course, other viruses, along with parasites, fungi, and bacteria continue to pester us. One of the most common infectious threats is the bacteria Streptococcus Pneumoniae. It causes pneumonia (infection of the lungs), sinus infections, meningitis (infection of the lining of our brain and spinal cord), ear infections, and sepsis (bacteria in the bloodstream). Just as there are multiple forms of Covid such as alpha, delta, and omicron, there are also multiple forms of Strep Pneumoniae we call serotypes.  

There are fortunately vaccines that protect us from many of Strep Pneumonia’s serotypes. To stimulate our immune systems to respond to the bacteria, the vaccines contain materials from the capsule that surrounds Strep Pneumoniae. One vaccine that we have long given to reduce the risk of infections from Strep Pneumoniae is called Pneumovax-23. It protects against 23 serotypes of Strep Pneumoniae. 

While Pneumovax-23 reduces the risk of bacteria entering the bloodstream if you get pneumonia, but doesn’t protect against pneumonia itself. That’s because presenting our immune system with the bacteria’s polysaccharide doesn’t provoke a very robust, enduring immune reaction. To solve this problem, scientists attached bacteria’s polysaccharides to a protein that causes a stronger immune response, creating what are called conjugate vaccines. Conjugate vaccines activate parts of the immune system called memory B cell and T cells. For many years, the only conjugate vaccine that protects against Strep Pneumoniae was called Prevnar-13. 

Until recently Centers for Disease Control (CDC) guidelines were to give people 65 and older one shot of Prevnar-13 and then 1 year later Pneumovax-23. Each shots were given once in people’s lives after age 65. We also gave Prevnar-13 and Pneumovax-23 to younger people with certain health conditions that made them higher risk of getting a severe infection with Strep Pneumoniae. 

Recently two new conjugate vaccines for Strep Pneumoniae were created and approved for use by the FDA. They protect against more serotypes of Strep Pneumoniae than Prevnar-13 and thus replace it. The pneumococcal conjugate vaccine 15 (PCV15) called Vaxneuvance protects against 15 Strep Pneumoniae serotypes. The pneumococcal conjugate vaccine 20 (PCV20) called Prevnar-20 protects against 20 Strep Pneumoniae serotypes.

Under the new CDC guidelines people 65 years and older and those 19-64 years old who are immunocompromised or have underlying health conditions and haven’t received Prevnar-13 should receive Vaxneuvance (PCV15)  or Prevnar-20. If Vaxneuvance (PCV15) is used, Pneumovax-23 should be given one year later. If Prevnar-20 (PCV20) is used, no further pneumococcal vaccines are needed. If you already received Prevnar-13 and Pneumovax-23, CDC guidelines state you do not need to receive Prevnar-20 or Vaxneuvance.

One other new recommendation from the CDC is that the shingles vaccine called Shingrix is now recommended for people 19 and older who “have weakened immune systems because of disease or therapy.” For people with normal immune systems, Shingrix is still only recommended for people 50 years and older.

In other vaccine news: There are reports that the CDC will soon offer a 4th shot of the Covid vaccine as an option for people 50 years and older whose 3rd shot was 4 or more months earlier. As time permits, I’ll address this in a future post. 

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Posted by on March 27, 2022 in Uncategorized


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